Quality Specialist

• Balance direct patient care with provider coaching and quality improvement across Rula’s 1099 psychiatric network
• Conduct chart reviews and identify clinical, coding, and documentation issues
• Deliver empathetic, direct feedback to providers
• Translate clinical findings into actionable improvement plans
• Cultivate strong, supportive relationships through peer outreach
• Apply clinical judgment and organizational skills to support clinical excellence
• Report directly to the Associate National Medical Director

Psychiatric quality specialist improving remote mental healthcare through PMHNP care, audits, and provider coaching

Psychiatric Quality Specialist

Psychiatric quality specialist supporting Rula’s remote mental healthcare through direct PMHNP care, chart audits, and provider coaching. Improving clinical documentation, coding compliance, and quality across a 1099 psychiatric network.

• Build and maintain strong relationships with provider offices and clinic leadership.
• Conduct onsite and virtual provider outreach visits to review quality performance metrics, identify improvement opportunities, and retrieve relevant care gap closure data/records.
• Collaborate with assigned provider offices and health plans to improve documentation, coding accuracy, and care gap closure.
• Collect, review, and validate medical records to ensure accuracy and completeness for reporting purposes.
• Educate providers and office staff on quality measures, documentation standards, coding requirements, and best practices.
• Support monthly supplemental data submission, file preparation, and verification of compliant coding.
• Work with internal teams and vendors to validate, reconcile, and audit HEDIS records to ensure completeness and accuracy.
• Assist in developing QI initiatives such as outreach campaigns, provider education, and workflow optimization.
• Assist practices with workflow optimization, patient outreach strategies, and quality improvement interventions.
• Serve as a quality performance resource to assigned health plan partners, provider groups, clinics, and MSOs, providing and presenting HEDIS performance scorecards monthly.
• Monitor HEDIS progress dashboards and address data gaps prior to final submission.
• Prepare reports, scorecards, and presentations for leadership review.
• Obtain data needed for Primary Source Verification audits from health plans and vendors and ensure timely submission.
• Act as a subject matter expert on CMS, HEDIS, NCQA, HIPAA, and health plan standards.
• Conduct comprehensive training for PCPs and specialists on Quality Measures, HEDIS and CMS Star Ratings, Performance-Based Incentive Programs, Data Accuracy and Documentation Standards.
• Perform additional duties and projects assigned.

Quality Care Improvement Specialist supporting healthcare quality metrics for Astrana Health

Quality Care Improvement Specialist

Quality Care Improvement Specialist responsible for healthcare quality improvements and metrics at Astrana Health. Leading initiatives to enhance HEDIS and CMS ratings within Southern California IPAs.

• Conducts compliance audits of difficult & complex documentation and data
• Approve use of Design History Records, Device Master Records, Nonconformances, Document Changes, Validations and Change Controls
• Demonstrates working knowledge of Quality Control, Manufacturing and Inventory processes
• Leads internal, external & 3rd party audits
• Reviews Customer Notifications and prepare, approve & submit data packages for external customers
• Supports internal and/or external audits in compliance with ISO 13485 and 21CFR820 requirements
• Participates in 3rd Party Audits from regulatory bodies including the FDA, notified bodies and business partners
• Assists in developing quality systems & make recommendations for improvements to existing Quality systems
• Approves compliance assessments & interfaces with other departments

Quality Specialist conducting compliance audits and ensuring quality standards

Quality Specialist conducting compliance audits and ensuring adherence to quality standards at Grifols, a global healthcare company.

• Support quality improvement initiatives and activities across multiple Behavioral Health programs and sites.
• Coordinate compliance activities, conduct audits, monitor documentation standards, and provide data reporting.
• Organize and provide summary reports that alert the BH Quality Improvement Manager and Leadership of upcoming chart compliance requirements.
• Ensure compliance with regulatory notices, safety practices, and environment of care standards.
• Conduct quality control test calls to assess the veracity and quality of service claims.
• Conduct internal chart audits to ensure compliance with State (DHCS), county, and contract standards.
• Monitor provider documentation for accuracy, timeliness, and technical compliance.
• Utilize the electronic health record (EHR) system to create reports, templates, and tracking tools for compliance monitoring.
• Monitor and facilitate staff compliance with HIPAA, W&IC, and other efforts to preserve the integrity of protected health information.
• Track and report service volume and productivity by program, team, and provider.
• Establish and maintain working relationships with internal teams and external county representatives.
• Support Clinic Managers and Leadership to ensure staff compliance with EHR requirements and required training.
• Independently prioritize workload across multiple assignments to meet competing deadlines.
• Identify compliance risks and proactively escalate issues to Leadership.

Float Quality Improvement Specialist supporting quality initiatives across Behavioral Health programs

Float Quality Improvement Specialist

Float Quality Improvement Specialist supporting quality initiatives across multiple Behavioral Health programs. Coordinating compliance activities and conducting audits to maintain regulatory standards.

• Prepares and maintains Quality directives, policies, processes, procedures and metrics to assure program, contract, customer, regulatory requirements, international standards and working agreements are deployed
• Reviews proposals, contracts, regulatory, program and customer requirements ensuring early quality involvement in program development
• Analyzes process data, metrics, models and flows to identify root cause of problems
• Participates with stakeholders to develop potential preventive or corrective actions and implementation
• Conducts research, compiles and analyzes performance reports and process control statistics, to continuously improve process capability
• Conducts quality source selection and process reviews of suppliers' ability to meet program quality requirements
• Conducts hardware, software and system level audits to determine compliance with quality management system standards
• Analyzes data to provide material review dispositions for nonconforming materials, parts and equipment

Quality System Specialist supporting Boeing Test and Evaluation Quality

Quality System Specialist

Quality System Specialist supporting Boeing Test and Evaluation Quality and ensuring compliance with requirements. Involved in audits, process analysis, and quality directive maintenance.

• Lead and organize training for all Quality Specialists on audit processes, procedures, and tools.
• Conduct complex audits and verifying quality standards for selected inquiries and make decisions whether discrepant information meets BCBSA and FEP audit requirements, state, and federal mandates.
• Provide second-level support on escalated issues and audit findings.
• Collaborate with team members, OCLD, and management to identify training gaps and business needs and implement actions while partnering to address these issues.
• Review, evaluate, and provide feedback on trainees’ audits and learning processes.
• Act as a consultant with external departments to help resolve high-impact business issues by recommending action plans related to quality assurance.
• Assist the Data Reporting Analyst in collecting data and providing analyses for various issues across the department and other functional areas.
• Foster a training and auditing culture that values diversity of thought, leveraging team member strengths to achieve team goals.
• Assist with external audits and lead special projects.
• Perform other duties as assigned.

Quality Specialist III ensuring compliance and conducting complex audits at Premera.

Quality Specialist III

Quality Specialist III role at Premera focusing on compliance, quality assurance, and auditing within healthcare services.

• Lead quality efforts for our flagship creative app in the role of a Senior Software Quality Engineer on the Projects & Collaboration team for Premiere Pro.
• Help define what outstanding work means.
• Collaborate with engineers, designers, and product managers to spot problems early, develop reliable test frameworks, and ensure customers have the best experience possible.
• Compose, build, and maintain automated test frameworks and test suites for Mac and Windows native applications using C++ and/or TypeScript.
• Define and drive quality strategies across multiple product teams, influencing engineering culture and guidelines.
• Collaborate with senior engineers alongside product managers to detect risk areas early and develop test plans that ensure detailed coverage.
• Own end-to-end quality for complex desktop features, from functional validation to performance and stress testing.
• Identify, reproduce, and triage bugs with precision — working across codebases to pinpoint root causes and advocate for permanent fixes.
• Champion quality initiatives across the organization, driving continuous improvement in tooling, test infrastructure, and release processes.
• Mentor junior QE team members and lead by example in building a quality-first engineering approach.

Lead quality efforts for Premiere Pro as a Senior Software Quality Engineer

Senior Software Quality Specialist

Senior Software Quality Engineer leading quality efforts for Premiere Pro. Collaborating with teams to ensure best customer experience and developing automated test frameworks.

• perform internal audits of the manufacturing processes, products, and procedures
• verify the implementation of ISO policies and procedures
• work closely with quality assurance, manufacturing operations, and inventory control personnel
• perform random, in-process auditing designated by the quality manager/supervisor or lead
• assist with follow-up on quality-related problems
• inspect finished products, products being processed, incoming materials, parts, assemblies and test products for conformance to company standards
• check to ensure corrective action is being taken on failed lots
• research, resolve and communicate work problems to Supervisor and assist coworkers in solving problems
• document audit findings and records in quality database system
• train and interpret process procedures/work instructions/quality bulletins with departments being audited
• participate in special projects, such as auditing, training other departments or inspecting

Quality Specialist performing internal audits in manufacturing processes

Quality Specialist performing internal audits in manufacturing processes and verifying ISO policy implementations. Collaborating with operations and quality assurance to ensure standards compliance.

• Perform clinical validation to ensure measure accuracy and compliance with CMS requirements
• Conduct medical record abstraction for assigned measures
• Identify and resolve data and logic discrepancies in collaboration with internal teams and external vendors
• Support timely and accurate regulatory submissions
• Ideally, team members will be assigned to either Validation or Abstraction
• Cross-training will be provided to support workload balancing and team flexibility.

RN Quality Measure Specialist focused on clinical quality measures at Banner Health

RN Quality Measure Specialist

RN Quality Measure Specialist at Banner Health validating and abstracting clinical quality measures. Collaborating with teams to support regulatory and quality reporting initiatives in a remote work setting.

Quality Specialist jobs in California

See all jobs on JobTailor

Psychiatric Quality Specialist

Quality Care Improvement Specialist

Quality Specialist

Float Quality Improvement Specialist

Quality System Specialist

Quality Specialist III

Senior Software Quality Specialist

Quality Specialist

RN Quality Measure Specialist